The purpose of this feasibility study is to examine the benefits and cost- effectiveness of BEDSCAPES Patient-Centered Healing Environments in patients who have been hospitalized for congestive heart failure (CHF). BEDSCAPES consist of photographic quality murals of nature scenes (field and stream, seashore) coupled with corresponding nature sounds that are placed in patients' rooms. Exposure has been shown to reduce anxiety level and heart rate in patients awaiting cardiac catheterization and reduce the need for pain medications following surgery. The present project will extend these findings to patients who require prolonged periods of hospitalization and examine potential cost savings as well as health benefits. Demonstration of economic value will be critical to the commercial success of BEDSCAPES and related products aimed at improving the quality of patient-care environments. We will randomize 40 patients to receive BEDSCAPES or usual care. Main outcomes of interest are anxiety level, mood, heart rate variability, length of stay, and total costs. Baseline measurements will be made on Day l and follow-up measurements on Day 4. Patient satisfaction with the hospitalization will be measured 2 days after discharge by telephone survey. Both the empirical analysis and cost-effectiveness analysis will be performed according to intention to treat. PROPOSED COMMERCIAL APPLICATIONS: This project will show that "Bedscapes" provides positive health outcomes that have real economic benefits: They help reduce costs to the health provider, by decreasing medication and hospital stay time; and have the potential to increase provider revenues by increasing patient satisfaction. These data will help HEI, Inc. create breakthrough sales in the marketplace, converting its currently limited-scope sales into institution- wide ones. These larger sales will strengthen HEI's ability to attract the strategic marketing partners with whom it will make licensing arrangements.